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eor - women's health > Prenatal Diagnosis/Care > Flashcards

Prenatal Diagnosis/Care Flashcards

1
Q

recommended prenatal care schedule

A
  • 4-28 weeks: monthly
  • 28-36 weeks: biweekly
  • after 36 weeks: weekly
  • 38-40 weeks: delivery
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2
Q

2 supplements all prenatal women should take

A

folic acid
prenatal vitamin

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3
Q

folic acid recs prior to conception vs for secondary prevention

A

prior to conception: 0.4 - 0.8 mcg
secondary prevention: 4 mg

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4
Q

indications for prenatal Ca supplementation (2)

A

-high risk for gestional HTN
-low Ca intake

1,200-1,300 mg/day

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5
Q

vitamin A should be limited to _ during prenatal period

A

< 5,000 IU/day

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6
Q

full PE should be performed at the first prenatal visit

what should be done at each subsequent prenatal visit (7)

A

weight
BP
UA
fundal height
fetal heart rate
fetal position
+/- cervical exam

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7
Q

pregnancy weight gain recs for obese women

A

< 15 lb

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8
Q

gs (but impractical) test for proteinuria in pregnancy

A

24 hour protein excretion

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9
Q

fetal HR is usually audible by

A

12 weeks

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10
Q

fetal position by palpation can usually be determined at _ weeks

A

36

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11
Q

advanced maternal age

A

35 yo

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12
Q

consideration for advanced maternal age

A

offer genetic testing

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13
Q

expectant date of confinement (EDC) - due date can be calculated using

A

naegele’s rule:

1st day of LMP + 7 days - 3 mo + 1 year

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14
Q

initial prenatal visit should take place _ weeks after LMP

A

6

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15
Q

ACOG defines HTN as

A

SBP > 140
OR
DBP > 90

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16
Q

triple screen

A

AFP
HCG
estriol

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17
Q

quad screen

A

AFP
HCG
estriol
inhibin A

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18
Q

when should corionic villus sampling occur

A

10-12 weeks (end of 1st trimester)

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19
Q

when should amniocentesis occur

A

15-18 weeks (beginning of 2nd trimester)

20
Q

when should 75 g 2 hour glucose tolerance test be done

A

26-28 weeks

21
Q

when should group B strep test be done

A

35-37 weeks

22
Q

estimated gestational age by uterine size schedule

A

-12 weeks: pubic symphysis
-16 weeks: midway from symphysis to umbilics
-20 weeks: at umbilicus
-20-36 weeks: height in cm above pubic symphysis = weeks gestation

23
Q

prenatal screening tests: first trimester

A

11-14 weeks:

-US for nuchal transucency
-PAPP-A and hCG
-chronic villus sampling (CVS)

24
Q

elevated levels of PAPP-A and hCG are seen with

A

chromosomal abnormalities

25
Q

low levels of PAPP-A can be associated w.

A

Down’s syndrome

26
Q

prenatal screening test: 10 weeks

A

cell free fetal DNA (fetal DNA in maternal blood)

27
Q

what does cell free DNA test for

A

-trisomies of 13, 18, 21
-if positive -> amniocentesis

28
Q

what does chronic villus sampling test

A

placental tissue for chromosomal/genetic abnormalities

29
Q

prenatal screening test: 16-18 weeks

A

quadruple screen

30
Q

elevated AFP indicates

A

neural tube or abdominal wall defects

31
Q

quad screen indicative of down syndrome

A

elevated hcg and inhibin
PLUS
decreased AFP and estradiol

32
Q

quad screen indicative of edwards syndrome

A

elevated AFP, Hcg, and estradiol

33
Q

prenatal screening test: 15-20 weeks

A

amniocentesis

34
Q

prenatal screening test: 24-28 weeks

A
  1. 1 hr glucose challenge test
  2. if abnormal: glucose tolerance test
35
Q

prenatal screening test: 35-37 weeks

A

lower genital swab for GBS

36
Q

6 symptoms of pregnancy

A

amenorrhea
increased urinary frequency
breast engorgement
nausea
hyperpigmentation
cervical softening

37
Q

urine pregnancy test detects _ (2)
and is sensitive starting at _ weeks pregnancy

A

hCG OR beta subunit
1-2 weeks

38
Q

most accurate method to detect fetal size

A

US

39
Q

US detection can detect the following at what gestational ages:

gestational sac:
fetal image:
cardiac activity:

A

gestational sac: 5 weeks
fetal image: 6-7 weeks
cardiac activity: 8 weeks

40
Q

procedure where small samples of placenta are acquired to perform prenatal genetic analysis

A

chronic villus sampling

41
Q

5 indications for chronic villus sampling

A

-maternal age > 35 yo
-prior child w. genetic d.o
-parents are carriers of genetic d.o
-1st trimester US suggestive of congenital anomaly
-abnormal aneuploidy screening result

42
Q

2 risks of chronic villus sampling

A

-maternal alloimmunization
-vertical transmission of infxn (ex HIV)

43
Q

2 complications associated w. chronic villus sampling

A

miscarriage
amniotic fluid leakage

44
Q

2 routine 3rd trimester tests

A

UA
BG

45
Q

when should RhoGAM be given if indicated

A

28-30 weeks

46
Q

mothers w. pre gestational DM should undergo twice weekly non stress testing until delivery between _ weeks

A

28-32

47
Q

when should cervical chlamydia and gonorrhea cultures be done if indicated

A

36-40 weeks

eor - women's health (15 decks)

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